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16. In his written arguments the counsel for the opposite parties stated that the complainants had fraudulently mentioned the monthly income of the patient as Rs.4000 while taking treatment whereas while claiming compensation the income is stated to be RS.20338 per month. The complaint is not maintainable against JIPMER being an institution of national importance providing free treatment to the patient. Cases of medical negligence has to be considered in the light of the guidelines laid by the Hon'ble Supreme Court. Professor Dr.Latha who performed surgery is an expert in the field of gynecology and a highly skilled professional and trained to handle laparoscope and perform surgeries. She has been doing laparoscopy procedure since 1995 and handling classes for undergraduate and postgraduate students. On an average 4 to 5 major laparoscopic procedures are performed in a month. Laparoscopy was performed on the patient on 28 .12.2015 by a team of three doctors headed by the Opposite party no.1 and the other doctors were Dr. Sasirekha who was an associate professor of gynecology and Dr.Nasareen. Opposite party 1 has all the awareness and knowledge of new advanced discoveries and developments in her field. The Opposite party 1 had advised the patient to take the opinion of doctors in surgery so as to ascertain the state of affectation. The victim girl without complying with the advice and direction had straight away come to the first Opposite party for treatment. During laparatomy second surgery it was found that there was perforation on caecum and the damaged portion was removed and necessary procedure was done to set it right. Caecum is on the upper part about 5 to 7 cm above the ovaries and therefore there is no possibility not probability of caecum being injured while performing the laparoscopic surgery. While doing cauterisation using guarded bipolar diathermy probe at the ovaries there is no possibility of causing injury to the caecum and the bipolar diathermy probe is found to be effective in localising the source of bleeding. The patient left the JIPMER hospital on 28.1.2015 against the advice of the doctors. The allegation that JIPMER hospital is lacking in infrastructure and the instruments used in the surgery were not sterilized is denied. The patient was taking treatment at Bangalore, Apollo hospital Chennai. CW.2 Dr. R.Karthikeyan and Dr.Narayan in Puducherry were also treating her. The other doctors and hospitals should also have been impleaded as party to the proceeding. The claim has not been substantiated with proof of any credible documents or medical literature. Evidence of CW.2 and CW.3 do not support the case of the complainants .The complainant ought to have examined any experts in the field or ought to have referred the case to a medical board of experts for their expert opinion. The complainants have failed to prove each and every allegation of negligence. The complainants had insisted on performing laparoscopic cystectomy with a false sense of modesty lest the scars of open surgery should remain on their unmarried daughter and had chosen to do laparoscopic cystectomy.

69. .In "Bowel injury in gynecologic laparoscopy :systematic review" an article published in Document Gynecology 2015 authored by Natalia C llarena it has been stated

70. "Overall incidence of bowel injury in gynecologic laparoscopy is one in 769 but increases with surgical complexity. Delayed diagnosis is associated with a mortality rate of 1 in 31."

2.As per medical text book - Te Linde's 'Operative Gynaecology' - John A.Rock and Howard W.Jones III Chapter 16 'Diagnostic and Operative Laparoscopy 70(1) "Complications of laparoscopy :

" The most serious laparoscopic intestinal injuries are those that go unrecognized at the time of surgery . Thermal injury from electrocautery or laser can have a potentially disastrous outcome."(Emphasis supplied)
3."Bowel injury following gynecological laparoscopic surgery" - Hassan M Elbiss and Fijri M Abu- Zidan in African Health Sciences 2017 Dec 17(
4) "Bowel injury is a serious complication of gynecological laparoscopy. Its incidence depends on the treated pathology and the type of procedure (diagnostic, minor operative, or complex operative). Lack of surgeon's experience and presence of previous abdominal surgery increase the risk of bowel injury. The incidence of bowel injury is 0.13% for laparoscopy procedures. The most common site of bowel injury was the small bowel, followed by the large bowel and stomach.2 This is in agreement with a recent systematic review which has shown that the incidence of bowel injury in gynecologic laparoscopy is 1 in 769.3"

77. As per "Bowel injury as a complication of laparoscopy " article published in British Journal of Surgery in 2004 -author M van der Voort et al "Bowel injury is a rare but serious complication of laparoscopic surgery."

"At 0.13% the incidence of laparoscopy induced bowel injury is small and such injuries are usually discovered during the operation. Nevertheless Laparoscopy induced bowel injury is associated with a high mortality rate of 3.6%"

78. Thus it is clear that gynaecologic laparoscopy can cause bowel injuries.Thus the argument of the Opposite parties that there is no possibility of caecum being injured due to laparoscopic surgery is not acceptable.